Moving to a care home with dementia

This is a post on the Demention blog, about a male carer and family looking after a mother with early onset dementia. This is about moving into a care home, the doubts, decisions and eventual success. It shows what can be valuable about care home care, although it does not discuss directly some of the disadvantages of a move with dementia that professionals might raise. However, here it is being done at a fairly early stage of the patient's progression, and it shows what efforts were made to connect her with her life history.

Link to the Demention blog post.

Private care home: rust-stained extended old houses are a reversion to the past

Another of my occasional pictures of facilities for older people, in this case, a care home in south Sutton.

It is typical of many private care homes both in its location and in the building. South Sutton is the formerly classy area of this suburb, on the southern border of London, merging into Surrey stockbroker belt. Some of this area still contains giant houses worth from a half mill to £2m or so, with extensive grounds. When we moved here ten years ago, an estate agent looked us over and said: 'Well, you'll be wanting to look in south Sutton, won't you?'

But nearer to the town centre, the big Edwardian houses are multi-occupied, or knocked down and replaced by larger blocks of flats, or simply converted into flats or, the concern of this blog, translated into care homes.

Here is an unprepossessing example, with the off-putting rust stains on the outside cladding and the bizarre design presumably cramming more rooms into the site than the big old house that previously occupied it. Looking at the side of it, it seems to have been extended both front and back. Domestic scale and Edwardian style are lost.

Because of its building, this is not a care home that can make nostalgic claims of connection with leisurely Edwardian gentility, or of convenient modernity. Local authorities, when they ran residential care, gave up the inconvenient and mobility-inhibiting conversions of large gentlemen's residences and went for newbuild on grounds of efficient service provision and convenience and independence for residents. A lot of the large-house converted private sector care homes are an uninspiring reversion to the past.

The aim of active retirement is only to put off deterioration. Discuss.

The niggle has become a clarity.

I’m now approaching the anniversary of my retirement; it’s been a year. I was planning to write about how I was experiencing retirement regularly, but I haven’t, because I haven’t had anything to say.

When I got to the six-month mark, I started to write, but did not think it worth publishing. This was it: ‘The new time structure that I remarked upon at three months is quite ingrained: daily organ practice, daily work on writing or blogs, with greater pressure on the writing as deadlines approach, and occasional ‘real’ retirement days of going out etc. Of course, I’ve just experienced Christmas and New Year, which connects us up with the wider family.’

And there I ran out of things to say. Thinking about this, I had the vague feeling that there was something hanging about in the back of my mind about ‘the next change is when I die’. But that seemed overly dramatic, I couldn’t grasp the niggle that was twitching there, so I let it be.

Then Margaret fell out of the loft and broke her collarbone, the electronics on the church organ phutted and the ‘ingrained’ routine deroutinised. I spent a few weeks chasing round over treatment for Margaret and her two nights in hospital after A&E and for a titanium plate being inserted in her shoulder. I’ve spent most of the last six months doing more in the kitchen and around the house because she has had residual back problems, and is improving only slowly.

 

What this has made clear is the risk that as physical things happen to us in old age, the outcome is an extra bit of incapacity. And you can see the incapacity inexorably leading to less mobility, more problems until, perhaps ten of fifteen years hence, fading away towards exclusion from the active world and death.

So I want to defend myself against events, such as falls and illnesses, that will move that process on. And I feel I want to keep on walking rather than busing, doing things rather than relaxing, continuing to write books and articles rather than staying with the easier stuff like blogs.

Is the objective of an active retirement only to put off deterioration and death? I’m now clear that is the question that is creating the niggle, but I don’t know the answer - yet. I wonder how others feel about it.

After the grandchildren...

'And the little one said...' The spare room after some of our grandchildren visited. Why are our dolls so elderly and decrepit? It's not a metaphor for the stage of our lives, we're grandparents. That means our dolls are from the previous generation or charity shops.

Inequality care or luxurious workhouse: high end care and support

 Another of my series of local older people's care facilities. This time we're at the very luxy end of the market - this place is renowned as the posh place to go. And you see they have a 'special neighbourhood' for the memory impaired - you can either see this as tactful or twee. And should we really encourage a public perception that dementia that requires care is really about being 'memory impaired'?
  

The main entrance is hotel like - although a lot of it seems to be flatlets. I've not been in, but one imagines smart communal accommodation, and as you can see the selling schtick encourages a hotel lounge sort of approach.

But the place is gigantic - there are several wings; or perhaps I should say 'neighbourhoods'. In fact it's workhouse-sized; and quite a large workhouse at that, although in this case, I imagine the taxpayers are not making any sort of contribution. This is really social inequality red in tooth and claw.






Another workhouse feature is that it's on the edge of town, so, as in the workhouse era, people are excluded from general view, and residents have little chance to go to shops, nice and Surrey-like though they are, under their own steam, unless they can still drive.






However, luxurious, then, is this the, possibly isolating, kind of living most older people really want, when research suggests that it's family networks that are most important to them?

Equipment if you need help with a little decrepitude

You see here a perching stool in our kitchen - this is a new acquisition; it makes life easier around the kitchen, indeed anywhere you need to stand when you have a bad back. Searching the the catalogue from OT Stores in Malvern (we were given it by an occupational therapist friend), we see an amazing number of things you can get for easing any number of practical difficulties as you get less able to do stuff. It's encouraging that there are so many possibilities, and perhaps discouraging that we know so little about it.

This is very solidly built, adjustable, cleanable but (question) does it have to be so institutional in style? Or is the definition of institutional something useful?

Has your room got its own mood? The latest silly decorating trend?

The National Trust magazine tells me (in passing in an article about planning your garden) that I need a mood board for each room in my house - I suppose I'm supposed to think what mood I'd like to be in in each room and adapt accordingly. I learned when we had a new lighting system in the church that it was adjusted according to moods in the services and in each area of the church; it brightens up when the service starts, for example, and when the choir's singing we get brighter lights.

Presumably I'm supposed to think about lighting schemes for my house, according to mood. When I'm depressed, the lights are lowered and black dogs reflected on the ceiling. Or do I just have to have the news projected on the wall? Do my happy family pics revolve like the portraits in the Murgatroyd Mansion (you have to have a background in Gilbert and Sullivan to know what this means), replacing cheerful snaps of weddings with family funerals?

Bur mainly I'm depressed that such a nonsense is being foisted on us as an innovation. I don't want my house to reflect my mood, and I don't want to move from room to room according to the mood I'm feeling. I suppose I might want the mood to be upbeat to keep me cheerful. And do people visiting stop looking at the decoration and the gadgets and instead do psychological assessments of the mood?

I'll consider a mood blog. Or it occurs to me perhaps I already have one - my more or less daily self-positioning blog probably has different photos and questions according to my mood. Look and see if you can assess it...http://self-positioning.tumblr.com/. But don't look at my less frequent end-of-life care blog, probably most people find that project depressing... http://sweol.wordpress.com/.